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https://www.readbyqxmd.com/read/29764915/remote-physiological-monitoring-in-an-austere-environment-a-future-for-battlefield-care-provision
#1
Matthew J Smyth, J A Round, A J Mellor
Wearable technologies are making considerable advances into the mainstream as they become smaller and more user friendly. The global market for such devices is forecasted to be worth over US$5 billion in 2018, with one in six people owning a device. Many professional sporting teams use self-monitoring to assess physiological parameters and work rate on the pitch, highlighting the potential utility for military command chains. As size of device reduces and sensitivity improves, coupled with remote connectivity technology, integration into the military environment could be relatively seamless...
May 14, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29760854/peritoneal-dialysis-in-austere-environments-an-emergent-approach-to-renal-failure-management
#2
REVIEW
Chad Gorbatkin, John Bass, Fredric O Finkelstein, Steven M Gorbatkin
Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power. PD is a mainstay of end-stage renal disease (ESRD) therapy worldwide, and the ease of initiation and maintenance has enabled it to flourish in both resource-limited and resource-abundant settings. In natural disaster scenarios, military conflicts, and other austere areas, PD may be the only available life-saving measure for acute kidney injury (AKI) or ESRD...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29718928/enteral-resuscitation-with-oral-rehydration-solution-to-reduce-acute-kidney-injury-in-burn-victims-evidence-from-a-porcine-model
#3
Belinda I Gómez, Matthew K McIntyre, Jennifer M Gurney, Kevin K Chung, Leopoldo C Cancio, Michael A Dubick, David M Burmeister
Intravenous (IV) resuscitation of burn patients has greatly improved outcomes and become a cornerstone of modern burn care. However, the heavy fluids and vascular access required may not be feasible in austere environments, mass casualty, or delayed transport scenarios. Enteral resuscitation has been proposed for these situations; we sought to examine the effectiveness of this strategy on improving burn-induced kidney injury. Anesthetized Yorkshire swine sustaining 40% TBSA full-thickness contact burns were randomized to three groups (n = 6/group): fluid deprivation, ad libitum water access, or 70 mL/kg/d Oral Rehydration Salt solution (ORS)...
2018: PloS One
https://www.readbyqxmd.com/read/29628662/prehospital-ultrasound-in-trauma-a-review-of-current-and-potential-future-clinical-applications
#4
REVIEW
Tharwat El Zahran, Mazen J El Sayed
Ultrasound (US) is an essential tool for evaluating trauma patients in the hospital setting. Many previous in-hospital studies have been extrapolated to out of hospital setting to improve diagnostic accuracy in prehospital and austere environments. This review article presents the role of prehospital US in blunt and penetrating trauma management with emphasis on its current clinical applications, challenges, and future implications of such use.
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29615073/advanced-airway-management-in-hoist-and-longline-operations-in-mountain-hems-considerations-in-austere-environments-a-narrative-review-this-review-is-endorsed-by-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#5
REVIEW
Urs Pietsch, Jürgen Knapp, Oliver Kreuzer, Ludwig Ney, Giacomo Strapazzon, Volker Lischke, Roland Albrecht, Patrick Phillips, Simon Rauch
BACKGROUND: Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotracheal intubation is the gold standard to secure the airway in the prehospital setting. This review aims to highlight special considerations for advanced airway management preceding human external cargo (HEC) evacuations. METHODS: We systematically searched MEDLINE, EMBASE, and PubMed in August 2017 for articles on airway management and ventilation in patients before hoist or longline operation in HEMS...
April 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#6
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29589329/tactical-neurocritical-care
#7
Julio A Chalela, Patrick E Britell
Neurocritical care is usually practiced in the comfort of an intensive care unit within a tertiary care medical center. Physicians deployed to the frontline with the US military or allied military are required to use their critical care skills and their neurocritical skills in austere environments with limited resources. Due to these factors, tactical critical care and tactical neurocritical care differ significantly from traditional critical care. Operational constraints, the tactical environment, and resource availability dictate that tactical neurocritical care be practiced within a well-defined, mission-constrained framework...
March 27, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29589042/-hemostyptics-for-treatment-of-junctional-vascular-injuries-management-of-traumatic-vascular-injuries-at-the-transition-from-trunk-to-extremities
#8
REVIEW
D C Hinck, S Wipper, E S Debus
BACKGROUND: Uncontrolled post-traumatic bleeding is still the leading cause of death among trauma patients. In situations of mass casualty incidents (MASCAL) and military conflicts the treatment of uncontrolled critical bleeding is a challenge and associated with a worse outcome due to the austere environment; however, even under optimal treatment circumstances in situations of individual medicine the severity of vascular trauma is underestimated. As a consequence, this leads to a poorer prognosis for patients with (vascular) injuries...
March 27, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29580444/medical-simulation-as-a-vital-adjunct-to-identifying-clinical-life-threatening-gaps-in-austere-environments
#9
Adaora M Chima, Rahul Koka, Benjamin Lee, Tina Tran, Onyebuchi U Ogbuagu, Howard Nelson-Williams, Michael Rosen, Michael Koroma, John B Sampson
BACKGROUND: Maternal mortality and morbidity are major causes of death in low-resource countries, especially those in Sub-Saharan Africa. Healthcare workforce scarcities present in these locations result in poor perioperative care access and quality. These scarcities also limit the capacity for progressive development and enhancement of workforce training, and skills through continuing medical education. Newly available low-cost, in-situ simulation systems make it possible for a small cadre of trainers to use simulation to identify areas needing improvement and to rehearse best practice approaches, relevant to the context of target environments...
April 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29579487/factors-affecting-the-delivery-of-healthcare-on-a-humanitarian-operation-in-west-africa-a-qualitative-study
#10
Di Lamb
INTRODUCTION: Medical personnel in the UK Armed Forces are highly trained to deploy in support of military operations that assist humanitarian, peacekeeping, counter-terrorism and environmental catastrophes anywhere in the world. Such environments are often austere and successful outcomes demand an individual is highly resilient and able to adapt quickly to any situation. This qualitative study aimed to determine the factors that affect healthcare delivery on such missions by capturing the personal experiences of the first military personnel deployed on a humanitarian operation in support of the Ebola outbreak in West Africa between October 2014 and January 2015...
April 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29576244/exploring-the-training-and-scope-of-practice-of-gps-in-england-germany-and-spain
#11
Ketevan Glonti, Verena Struckmann, Alvaro Alconada, Luisa M Pettigrew, Virginia Hernandez-Santiago, Sergio Minue, Isabelle Risso-Gill, Martin McKee, Helena Legido-Quigley
OBJECTIVE: To explore general practitioner (GP) training, continuing professional development, scope of practice, ethical issues and challenges in the working environment in three European countries. METHOD: Qualitative study of 35 GPs from England, Germany and Spain working in urban primary care practices. Participants were recruited using convenience and snowball sampling techniques. Semi-structured interviews were recorded, transcribed and analysed by four independent researchers adopting a thematic approach...
March 22, 2018: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29538232/preparation-of-leukoreduced-whole-blood-for-transfusion-in-austere-environments-effects-of-forced-filtration-storage-agitation-and-high-temperatures-on-hemostatic-function
#12
Joar Sivertsen, Hanne Braathen, Turid Helen F Lunde, Philip C Spinella, Warren Dorlac, Geir Strandenes, Torunn O Apelseth, Tor A Hervig, Einar K Kristoffersen, Level Iv Diagnostic Study
No abstract text is available yet for this article.
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29533453/medicine-on-the-edge-of-darkness
#13
Peter Anders Christensen
Austere care of the wounded is challenging for all Western medical professionals-nurse, medic, or physician. There can be no doubt that working for the first time, either for a nongovernment organization or in the Special Forces, you will be taking care of wounded patients outside your training and experience. You must have the ability to adapt to and overcome lack of resources and equipment, and accept standards of treatment often very different and lower than that common in western hospitals. The International Committee of the Red Cross (ICRC) was asked to provide relief for the Pakistan Red Crescent in 1982 and set up the ICRC Hospital for Afghan War Wounded in Peshawar on the border to Afghanistan...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533439/lead-exposure-in-the-special-operations-shooter-how-to-prevent-cognitive-decline-and-permanent-disability
#14
Jonathan W Brandon, Justin K Solarczyk, Timur S Durrani
Lead toxicity is an important environmental disease and its effects on the human body can be devastating. Unique exposures to Special Operations Forces personnel may include use of firing ranges, use of automotive fuels, production of ammunition, and bodily retention of bullets. Toxicity may degrade physical and psychological fitness, and cause long-term negative health outcomes. Specific effects on fine motor movements, reaction times, and global function could negatively affect shooting skills and decision-making...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533432/feasibility-and-proposed-training-pathway-for-austere-application-of-resuscitative-balloon-occlusion-of-the-aorta
#15
Elliot M Ross, Theodore T Redman
BACKGROUND: Noncompressible junctional and truncal hemorrhage remains a significant cause of combat casualty death. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective treatment for many junctional and noncompressible hemorrhages. The current hospital standard for time of placement of REBOA is approximately 6 minutes. This study examined the training process and the ability of nonsurgical physicians to apply REBOA therapy in an austere field environment. METHODS: This was a skill acquisition and feasibility study...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29523753/prospective-use-of-unmanned-aerial-vehicles-for-military-medical-evacuation-in-future-conflicts
#16
EDITORIAL
Charles Handford, F Reeves, P Parker
In order to continue to deliver outstanding medical care on the battlefield, the UK Defence Medical Services must continue to adapt, overcome and actively embrace change. One potential area is the rapid proliferation and sophistication of automated and remote systems such as unmanned aerial vehicles (UAVs). UAVs are already used to deliver blood to remote military locations in Afghanistan and defibrillators to those that need them in the USA and Sweden. An area of future opportunity would be to facilitate rapid evacuation of wounded personnel from high intensity, high threat, remote and austere areas directly to specialist care...
March 9, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29507873/anaesthesia-in-austere-environments-literature-review-and-considerations-for-future-space-exploration-missions
#17
REVIEW
Matthieu Komorowski, Sarah Fleming, Mala Mawkin, Jochen Hinkelbein
Future space exploration missions will take humans far beyond low Earth orbit and require complete crew autonomy. The ability to provide anaesthesia will be important given the expected risk of severe medical events requiring surgery. Knowledge and experience of such procedures during space missions is currently extremely limited. Austere and isolated environments (such as polar bases or submarines) have been used extensively as test beds for spaceflight to probe hazards, train crews, develop clinical protocols and countermeasures for prospective space missions...
2018: NPJ Microgravity
https://www.readbyqxmd.com/read/29463357/point-of-care-ultrasound-for-pulmonary-concerns-in-remote-spaceflight-triage-environments
#18
REVIEW
Benjamin D Johansen, Rebecca S Blue, Tarah L Castleberry, Erik L Antonsen, James M Vanderploeg
INTRODUCTION: With the development of the commercial space industry, growing numbers of spaceflight participants will engage in activities with a risk for pulmonary injuries, including pneumothorax, ebullism, and decompression sickness, as well as other concomitant trauma. Medical triage capabilities for mishaps involving pulmonary conditions have not been systematically reviewed. Recent studies have advocated the use of point-of-care ultrasound to screen for lung injury or illness. The operational utility of portable ultrasound systems in disaster relief and other austere settings may be relevant to commercial spaceflight...
February 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29447407/the-feasibility-of-venovenous-ecmo-at-role-2-facilities-in-austere-military-environments
#19
Mohamed A T Mohamed, Tareq Maraqa, Matthew D Bacchetta, Michael McShane, Kenneth L Wilson
Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been gaining use to bridge the recovery from acute respiratory distress syndrome (ARDS) refractory to conventional treatment. However, these interventions are often limited to higher echelons of military care. We present a case of lung salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) facility in an austere military environment in Afghanistan. Case: A 25-year-old Afghani soldier presented to an R2 facility with blast lung injury and multiple penetrating injuries following an explosion...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29443864/past-and-present-role-of-ecmo-in-combat-casualty-care-how-far-will-we-go
#20
Jeremy W Cannon, Phillip E Mason, Andriy I Batchinsky
Advanced extracorporeal therapies have been successfully applied in the austere environment of combat casualty care over the previous decade. In this review, we describe the historic underpinnings of extracorporeal membrane oxygenation (ECMO), review the recent experience with both partial and full lung support during combat operations, and critically assess both the current status of the Department of Defense ECMO program and the way forward to establish long-range lung rescue therapy as a routine capability for combat casualty care...
February 13, 2018: Journal of Trauma and Acute Care Surgery
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